Easy As 1-2-3: Obtaining Health Insurance
In the United States, there are about five different types of health insurance available: traditional health insurance; preferred provider organizations or PPOs; point-of-service plans or POS; health management organizations or HMOs; and most recently, health savings accounts or HSAs. With so many types of health insurance, it may be confusing trying to figure out which one best fits your needs, so thoroughly research each and speak with a professional if you need clarification.
Health insurance is commonly obtained through an employer. Nearly all employers these days offer some sort of “group” health insurance plan for employees. The term “group” simply denotes that there is a large group of people on the plan, which decreases the cost of the monthly premium for all members. These plans can cover yourself, your spouse, and your family, depending on the specific policy.
With people living longer, health insurance companies began to look for more ways to reduce their costs, developing different health plans such as PPOs. PPOs are plans which will cover nearly all of your medical expenses as long as you stay within a preferred network of physicians or hospitals. This network creates a “preferred provider” list that you can choose from. Treatment outside this network of providers is covered but only at a reduced rate, meaning you end up paying more to see a physician outside the network. By limiting the physicians and hospitals covered in their network, the insurance company can control, to an extent, their costs and lower your premiums. POS plans work like PPOs, but require you to have a primary care physician through whom you can receive referrals for specialists. If you need to see a neurologist or a dermatologist, you must first visit your primary care physician for an initial diagnosis in order to receive a referral to a specialist for a more thorough diagnosis. POS plans also have a preferred provider network, and if you choose to visit a specialist or physician outside that network, your coverage will be limited.
If you leave an employer who offers group health insurance without first finding other coverage, you can also use the COBRA law with your previous employer’s health insurance coverage. COBRA is a government act that allows you to continue coverage under your previous employer, though at a more expensive rate. If you had coverage for your entire family, COBRA will allow you to continue this full coverage for a certain period of time.
Another item you should definitely consider is if your current physicians or specialists are included in the health insurance company’s preferred provider network or if you have the opportunity to choose any physician (often the case only with indemnity or traditional health insurance plans). If you would like the freedom to choose your own doctor, traditional health insurance plans or preferred provider organizations may offer more attractive plans – though these also cost a little more.
There is also federal health assistance available depending on certain criteria. If you are over the age of 65 or if you have a disability or specific condition (detailed by the government), you are eligible for Medicare. Medicaid is another government health insurance program that is based on income. Overall, it is simply important to be covered, no matter how you go about doing it. Research your options of coverage and speak with a professional to find out more about the health insurance options available to you.
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